ObjectiveTo evaluate clinical significance of serum free light chains (sFLC) in diagnosis and response to the therapies of patients with multiple myeloma (MM).MethodssFLC (κ,λ and κ / λ ratio)were examed by immumoassay from 62 patients with MM at different stage. The results were analyzed associated with clinical data,and 35 cases of chronic renal failure(CRF)patients and 62 cases of healthy donors were taken as controls.ResultsMedium sFLC of normal κ value was (13.25±6.46) mg/L,λ value was (18.39±11.42) mg/L; and κ / λ ratio was (0.97±0.64) mg/L (range 0.33-1.61).sFLC κ and λ of CRF patients were (200.01±299.87) mg/L,(191.02±245.98) mg/L,significantly higher than that of the normal control group (t =-17.804,-16.894,both P ＜ 0.001),but the κ/λ ratio was at normal range (1.11±0.29).κ value range was at 16.20- 35 250 mg/L in newly diagnosed intact immunoglobulin MM patients with IgGκ,IgAκ and IgDκ type.The range of λ values was 15.70-4885 mg/L in IgGλ,IgAλ,IgDλ type,and κ/λ ratio was abnormal in 96.5 ％ (55/57) patients (＜0.5 or ＞1.5).The κ,λ value and κ/λ ratio were close to that of the normal after remmision.ConclusionsFLC ( κ,λ,and κ / λ ratio) are very good monitoring markers for MM.

Objective To observe the effects of the re-therapeutic on later stage of sudden deafness.Methods Patients who met the criteria for sudden deafness and showed poor response tO conventional therapy over two months were recruited and assigned randomly for re-therapy.The pure tone audiometry was conducted before and after re-treatment in 103 patients(112 ears).Sodium bicarbonate and dexamethasone were iniected by intravenous drip for two days and batroxobin 5 BU for 6 days.Statistics were made in the effecency of the re-treatment.Results The effective rate of re-treatment group was 46.43% and the difference was significant before and after retreatment(P<0.01).Conclusion Combined use of sodium bicarbonate dexamethasone and batroxobin is effective in re-treating later sudden deafness.

Objective To investigate effects of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on endothelial function in elderly patients with essential hypertension. Methods Seventy-three elderly patients with uncomplicated essential hypertension and 55 normal elderly people as control were recruited into the study. Their humeral arterial endothelial vasodilatation function was studied with high-resolution ultrasonography and ACE I/D genotypes were determined by polymerase chain reaction (PCR) technique. Results Endothelium-dependent vasodilatation function of the three-genotype subgroups of the elderly patients with essential hypertension was significantly lower than that in the controls with the same genotypes (5.5±1.9 vs 11.9±1.3 in Ⅱ genotypa, 4.7±2.0 vs 10.9±1.6 in ID genotype and 2.9±1.9 vs 9.4±2.6 in DD genotype, with all P<0.01 ). In both groups of hypertensives and normotensives, humeral arterial endothelium-dependent vasedilatation function was significantly lower in those with DD genotype than that in those with Ⅱ genotype (2.9±1.9 vs 5.5±1.9 in hypertensive group and 9.4±2.6 vs 11.9±1.3 in control group, both P<0.05 ). Multivariate linear regression analysis showed that endothelium-dependent vasodilatation function in hypertensive elderly people correlated in linearity with their ACE genotype (P<0.01 ). Conclusions ACE gene I/D polymorphism is associated with abnormal humeral arterial endothelium-dependent vasodilatation function of humeral artery in patients with essential hypertension.

BACKGROUNDTo evaluate the efficacy and toxicity of the FUDR-based regimen in the treatment of advanced non-small cell lung cancer.

METHODSFifty patients in group A received the L/FUDR-EP regimen, while 42 patients in group B were given the L/FEP regimen. The response and toxicity were evaluated after three courses of treatment.

RESULTSThe therapeutic response of group A and group B were 40.0% and 38.1% respectively (P > 0.05). The toxicities such as marrow inhibition, gastrointestinal symptoms, alopecia and local phlebitis were remarkably lower in group A than those of group B (P < 0.01).

CONCLUSIONSThe FUDR based regimen is effective to the advanced NSCLC, and its toxicity is lower than 5-FU.

Objective To analyze the differentially expressed proteins in bone marrow supernatants of multiple myeloma patients by using 2-DE and MALDI-TOF-MS,and search for the special protein markers for studying the mechanism of the development and diagnosis or differential diagnosis of multiple myeloma.Methods The bone marrow supernatant samples of fourteen multiple myeloma patients,five other hematologic malignancies and five normal controls were collected.After removing albumin and IgG,the proteins in the supernatants were separated by 2-DE.Three groups images were analyzed and compared by Imagemnster 2D platinum 5.0 analysis software.Differentially expressed proteins were selected if the protein spots intensity showed more than 3 fold increase or decrease among different groups.The identities of the differentially expressed proteins with good repeatibility were determined by PMF based on by MALDI-TOF-MS or MALDI-TOF-MS/MS and NCBInr database search.Results 2-DE maps of bone marrow supernatants of the three groups could be analyzed and compared by image analysis of software.Forty-seven and fifty-eight differentially expressed protein spots were detected in multiple myeloma samples compared with normal controls and other hematologic malignancies samples,respectively.Forty-one reproducible spots were analyzed and identified by mass spectrum.Compared with other hematologic malignancies and normal controls,five up-expressed proteins and three down-expressed proteins were identified in multiple myeloma samples.They includes immunoglobulin J chain κ and λ light chain,provirus ancestral Gag polyprotein,mature oxy-cope catalytic antibody with hapten for up-expressed proteins,and hemoglobin,haptoglobin Hp2,zinc-alPha-2-glycoprotein for down-expressed proteins.These differentially expressed proteins reflect the features of muhiple myeloma,and relate to the development,progression and therapy of multiple myeloma.Conclusions Eight differentially expressed proteins in bone marrow supernatants of multiple myeloma are identified by using 2-DE and MALDI-TOF-MS.These differentially expressed proteins could be useful in studying the mechanism of the development and progression of multiple myeloma,and in developing diagnosis and differential diagnosis of multiple myeloma.

Objective:To establish a matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) method for the direct detection of serum M protein without antibody enrichment, and to assess its detection performance.Methods:Method establishment. A total of 712 waste serum samples were collected from patients who applied for the M protein identification test in Beijing Chaoyang Hospital affiliated to Capital Medical University. The immunoglobulin light chain was obtained by reduction of IgG and IgA by TCEP, and the detection method was preliminarily determined. The waste serum samples from 20 healthy people were collected to determine the range of mass-to-charge ratios of κ and λ light chain ions. 8 parallel tubes and 8 batches were set up for intra-and inter-batch reproducibility evaluation. 10-fold, 100-fold and 200-fold diluted M protein from 23 positive samples were detected by established MALDI-TOF MS method, and its sensitivity was evaluated. 3 methods of IFE, SPE and MALDI-TOF MS were used to detect M protein simultaneously, and the coincidence rate between MALDI-TOF MS and IFE and SPE was calculated.Results:The repeatability within and between batches was 100%, respectively. The original, 10-, 100-and 200-fold dilutions of 23 M protein-positive samples were determined, and the detection limit of MALDI-TOF MS for M protein was 0.06-0.18 g/L. IFE as the gold standard, the overall coincidence rates of SPE and MALDI-TOF MS were 85.9% and 92.3%, respectively, and the positive coincidence rates of SPE and MALDI-TOF MS were 72.8% and 99.7%, respectively, of the 712 samples. Among the different types of M-proteins, MALDI-TOF-MS agreed 100% with IFE M-protein results for IgA, IgD, IgM, free light chain type and biclonal group, while the agreements of SPE for IgM, IgA and free light chain samples were only 66.7%, 58% and 19.5%, respectively. One positive sample in the IgG group was not detected by MALDI-TOF MS. 23 M-proteins positive samples were diluted by original, 10, 100 and 200 times to access the sensitivity of MALDI-TOF MS method. The coincidence rate of MALDI-TOF MS was 100% and IFE was 96% at 10-fold dilution. The coincidence rate of IFE was 28% and 23% of MALDI-TOF MS at 100-fold and 200-fold dilution, respectively.Conclusions:A MALDI-TOF MS method for the detection of serum M-proteins was successfully established. This method has the advantages of high detection throughput, fast speed, good sensitivity, specificity and coincidence rate.

Objective:To compare the therapeutic efficacy and the recurrence rate between the simple repositioning method and the reposition manoeuvre plus medication in the treatment of horizontal semicircular canal otolith benign paroxysmal positional vertigo (HSC-BPPV). Method:Sixty-two patients diagnosed with otolith HSC-BPPV by roll maneuver test were randomly divided into canalith repositioning group (32 patients) and reposition plus drug treatment group (30 patients). Patients in the canalith repositioning group were treated only with Barbecue reposition maneuver; patients in the reposition plus drug treatment group were treated firstly with Barbecue reposition maneuver and then were given Alprostadil, Cinepazide and Betahistine drug treatment. Both groups were evaluated after 7 days and 28 days treatment, and the recurrence rate was analyzed after 3 months. Result:After 7 days of the treatment , the recovery rate of the two groups was 62.5% and 73.3%, respectively. There's no significant difference between the two groups. However, the total effective power of the reposition plus drug treatment group was 96.7%, which was significantly higher than that of the canalith repositioning group (75.0%) (χ²=5.858, P<0.05). There were 8 patients in the canalith repositioning group showed changes of BBPV types after treatment, while only 1 patient in the reposition plus drug treatment group showed lesion changes. The difference was statistically significant (χ²=4.061, P<0.05). After 28 days of the treatment, the recovery rate and the total effective power of the two groups was 100%, respectively. There is no statistical difference in the total effective rate between the two groups. After 3 months follow-up, 2 patients in the canalith repositioning group (6.25%) and in the reposition plus drug treatment group (6.67%) showed BBPV recurrence, and no significant difference in the recurrence rate was found between the two groups (P>0.05). Conclusion:The repositioning maneuver is the preferred method for treating HSC BPPV. Canalith reposition maneuver plus medication has no obvious effect on the recovery rate and the recurrence rate, it only increases the effective rate and reduces the changes of the BBPV types.

OBJECTIVE： To establish a method for simultaneous determination of α-pinene， β-pinene， limonene and α-terpineol in volatile oil of Forsythia suspensa. METHODS： GC method was adopted. The determination was performed on HP-5 capillary column through temperature-programmed route. The inlet temperature was 230 ℃， and detector temperature was 250 ℃； split sampling was applied （split ratio of 8 ∶ 1）； the air flow rate was 300 mL/min， the hydrogen flow rate was 30   mL/min， the tail gas flow rate was 30 mL/min， and the injection volume was 1 μL. Using limonene as internal reference， relative correction factors of α-pinene， β-pinene and α-terpineol were established， and the reproducibility of relative correction factors were investigated by using different chromatographs and columns， and chromatographic peak location of components was measured. The contents of above components were calculated with QAMS， and then compared with the results of external standard method. RESULTS： The linear range of α-pinene， β-pinene， limonene and α-terpineol were 16.5-990.0， 38.1-2 287.5， 8.2-491.2， 2.4-142.5  μg/mL， respectively （r≥0.999 1）. RSDs of precision， reproducibility and stability tests were all lower than 3％ （n＝6）. Average recoveries were 99.7％-105.5％（RSD＜4％，n＝9）. Compared with limonene （1.00），the average relative correction factors of α-pinene， β-pinene and α-terpineol were 0.91，0.86 and 1.11（n＝3）； relative retention time were 0.69-0.74， 0.81-0.86， 1.25-1.35（RSD＜3％，n＝3）. By using different chromatographs and columns， RSDs of relative correction factors were 0.21％-4.65％（n＝6）. Compared with external standard method， determination results of above 4 components were consistent （the absolute value of relative error were all less than 7％）. CONCLUSIONS： QAMS can be used for simultaneous determination of 4 kinds of effective components in volatile oil from F. suspensa.